Reimbursement Claim Form
When filing your claim for reimbursement, you must attach copies of the receipts. (Keep your original receipts for your records.)
The receipt must show the date and type of service for the expense. Canceled checks, credit card slips, or statements showing only a balance due on your account are not allowable.
Click here for a Reimbursement Claim Form.
Employee Enrollment Form
Click here for a Flex Enrollment Form.
Authorization for Direct Deposit of Reimbursement Claims
Click here for a Direct Deposit Form.
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*The above forms are in PDF format. |
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